topic Re: Email from Covered CA in Community Chat

Email from Covered CA

Say Nay — Tue, 16 Aug 2016 17:35:49 GMT

Did anyone else get this email from Covered CA regarding their "new feature"???? I wonder how may hoops I will have to jump through to switch back to my PCP. Not happy at all with this change.

Snip:

"...Beginning January 1, 2017 your health care insurance carrier will match you with a Primary Care Physician. Once your PCP has been matched you will be able to change to another physican at any time you choose.."

Re: Email from Covered CA

minkbunny — Tue, 16 Aug 2016 17:40:02 GMT

What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.

Re: Email from Covered CA

Say Nay — Tue, 16 Aug 2016 17:44:49 GMT

@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.

I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.

Re: Email from Covered CA

catwhisperer — Tue, 16 Aug 2016 17:56:12 GMT

@minkbunny....Delaware, Iowa, Nebraska and Virginia. I can't tell you how happy I am to be out of Covered CA. What a nightmare. I recently turned 65, so am on a Medicare Adv. plan now.

Re: Email from Covered CA

minkbunny — Tue, 16 Aug 2016 17:51:29 GMT

Thanks, I am also on Medicare and was THRILLED the day I turned 65. Best insurance on Earth. Not sure why the new sysem couldn't have been patterend after it. And the website is terrific !

Re: Email from Covered CA

terrier3 — Tue, 16 Aug 2016 18:08:12 GMT

@minkbunny wrote:
Thanks, I am also on Medicare and was THRILLED the day I turned 65. Best insurance on Earth. Not sure why the new sysem couldn't have been patterend after it. And the website is terrific !

I have worked in the HI industry and MANY fellow employees believe that Medicare for All is the way to go.

Basic insurance coverage for everyone, with the choice to purchase "medi-gap" type plans. This works in many other countries.

As someone who has sold marketplace insurance in NY, MANY people don't sign up for a primary physician. They think that the insurance is just for a catastrophe. ACA was set up in part to make sure that people see their primary MDs on a regular basis and get screened for illnesses. It costs less when people get treated early and also get advice on how to stay healthy.

Re: Email from Covered CA

Maudelynn — Tue, 16 Aug 2016 18:05:12 GMT

@minkbunny wrote:
Thanks, I am also on Medicare and was THRILLED the day I turned 65. Best insurance on Earth. Not sure why the new sysem couldn't have been patterend after it. And the website is terrific !

That would have been the ultimate, but universal coverage would not fly with the congress. ACA was the next best option to get millions more covered.

It just shows how greedy the insurance companies are. Aetna's stock price was at $37.00 when the ACA was put into place. Stock price now is $119.00. Someone's making a ton of money- but I guess it's just not enough.

Re: Email from Covered CA

terrier3 — Tue, 16 Aug 2016 18:14:53 GMT

@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.

The reasoning is that many people don't choose a primary MD. They wait until they are very sick.

If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.

Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.

Re: Email from Covered CA

Say Nay — Tue, 16 Aug 2016 18:19:56 GMT

@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.

It be more prudent to focus on those individuals rather than impose a blanket change in policy.

Re: Email from Covered CA

151949 — Tue, 16 Aug 2016 18:21:19 GMT

UHC does this to us every year - we call our regular PCP's office manager and she gets it changed back to our regular doctor.

Re: Email from Covered CA

terrier3 — Tue, 16 Aug 2016 18:32:20 GMT

@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.

It's one phone call.

Re: Email from Covered CA

Say Nay — Tue, 16 Aug 2016 18:46:19 GMT

@terrier3 wrote:
@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.
It's one phone call.

Not relevant.

I am on a PPO which pay more for so that I can make my own decisions. If I am kicked off from my current PCP who is in high demand there is no guarantee that I will be able to select her again.

Re: Email from Covered CA

ms traditional — Tue, 16 Aug 2016 21:48:31 GMT

the risk pool of ACA is not balanced. it's not just Aetna if you have been following the news (United Healthcare made a move in this direction and Blue Cross Blue Shield has commented on this issue too). the losses have been mounting due to an imbalance of those filing claims vs healthy younger sign-ups' offsetting premia. do the math.

Re: Email from Covered CA

terrier3 — Tue, 16 Aug 2016 21:48:16 GMT

@ms traditional wrote:
the risk pool of ACA is not balanced. it's not just Aetna if you have been following the news (United Healthcare made a move in this direction and Blue Cross Blue Shield has commented on this issue too). the losses have been mounting due to an imbalance of those filing claims vs healthy younger sign-ups' offsetting premia.

This entirely depends on where you live.

BCBS of WNY dropped some forms of ACA last year - they just took clients with higher incomes and lower premium tax credits.

They are now back into managed Medicaid, CHP and all ACA income levels.

The way insurance companies are reimbursed only is partially due to health levels of their enrollees. There is a lot involved behind the scenes.

Re: Email from Covered CA

terrier3 — Tue, 16 Aug 2016 21:49:09 GMT

@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.
It's one phone call.
Not relevant.

I am on a PPO which pay more for so that I can make my own decisions. If I am kicked off from my current PCP who is in high demand there is no guarantee that I will be able to select her again.

That is HER decision, not the marketplace.

Re: Email from Covered CA

Say Nay — Tue, 16 Aug 2016 22:28:31 GMT

@terrier3 wrote:

That is HER decision, not the marketplace.

And... so? That does not address my question/statement.

Re: Email from Covered CA

CelticCrafter — Tue, 16 Aug 2016 22:44:12 GMT

@The Monkey on My Back wrote:
Did anyone else get this email from Covered CA regarding their "new feature"???? I wonder how may hoops I will have to jump through to switch back to my PCP. Not happy at all with this change.

Snip:

"...Beginning January 1, 2017 your health care insurance carrier will match you with a Primary Care Physician. Once your PCP has been matched you will be able to change to another physican at any time you choose.."

They should absolutely not be allowed to do something like that.

Is there a way for you to opt out of it?

If you are happy with your current PCP, I think I would also notify them that you are not going to make the change the insurance company is recommending.

Re: Email from Covered CA

Allegheny — Wed, 17 Aug 2016 17:16:47 GMT

A little off topic.and I have to vent.

You know I am just sick of it all. The insurance companies, the pharmaceutical companies, the ACA, insurers dropping out of the ACA in certain states.

People trying to keep up to date, understand all the issues and provisions and having to jump through hoops. Seriously, what is wrong here?! Is this how it is supposed to work? Should it be so complicated? Our country and citizens deserve better than this.

Re: Email from Covered CA

CelticCrafter — Wed, 17 Aug 2016 19:27:50 GMT

https://www.healthforcalifornia.com/covered-california-forces-ppos-to-assign-primary-care-physicians

@Say Nay - I found this.

Re: Email from Covered CA

Say Nay — Wed, 17 Aug 2016 19:38:12 GMT

@CelticCrafter wrote:
https://www.healthforcalifornia.com/covered-california-forces-ppos-to-assign-primary-care-physicians

@Say Nay - I found this.

You are awesome! Thank you <3